PROJECT SUMMARY: OVERALL Latinos are the fastest growing ethnic group in the United States comprising almost half of the immigrant population and by 2060 are estimated to represent 29% of the total population. Although often treated as a homogeneous population, Latinos vary in culture as well as in genetic ancestry admixture. The former may influence symptom experience and responses as well as self-management needs. The latter influences disease risk and treatment responses, and Ancestry Informative Markers have been developed to quantify admixture for Latinos in the Americas. However, little is known about how these cultural and genetic factors interact in the context of symptom science. The goal of the Precision in Symptom Self-Management (PriSSM) Center is to advance the science of symptom self-management for Latinos through a social ecological lens that takes into account variability in individual, interpersonal, organizational, and environmental factors across the life course. The aims of the PriSSM Center are to: 1. Develop sustainable interdisciplinary, biobehavioral research capacity for symptom self-management research by establishing a sociotechnical infrastructure including centralized research resources, 2. Enable symptom self-management feasibility research that will develop into new programs of research and independent investigator research applications by supporting six pilot projects, 3. Advance symptom self-management for Latinos through synergistic research activities informed by a social ecological lens and precision medicine approaches, and 4. Assess the PriSSM Center activities, impact, and sustainability through formative and summative evaluation. To achieve the aims of the PriSSM Center, the Administrative and Pilot Projects Cores are complemented by a Precision Medicine Core. This aligns with the National Institutes of Health Symptom Science Model and its four components: 1) complex symptom or cluster identification, 2) phenotypic characterization, 3) biomarker discovery, and 4) clinical application. The Columbia University School of Nursing has a robust research base of symptom self-management studies. There are multiple areas of innovation within the PriSSM Center: use of the Social Ecological Model as the theoretical underpinning for the Center, application of data science methods, and the integration of Ancestry Informative Markers and genetic findings related to common and rare conditions as common data elements in all pilot projects. The PriSSM Center will use the exceptional institutional resources and the proposed research activities to reduce the knowledge gap related to the science of symptom self-management for Latinos of diverse heritage.